**3. Prevalence of mental distress among medical students in western countries vs. non-western medical students**

Dyrbye found the significantly higher frequency of mental distress among US and Canadian medical students than the general population [20]. Dahlin et al. [10] reported that 13% of Swedish medical students were depressed as compared to 7.8% in an age-matched control sample and, of further concern, one-third of the students reporting suicidal thoughts during the course of training. Another research study conducted in Australia involved 1811 medical students and concluded that one in five students reported suicidal thoughts over the past 1 year [27].

Studies from non-western countries also reported a high prevalence of mental distress [5, 7, 9, 13, 28–30]. There is a small but growing body of research that has recently emerged that attempts to determine the prevalence and the causes of mental distress among medical students of Pakistan. Pakistani study findings are not different from rest of the globe, and they also found high mental distress among medical students [17, 19, 31–33].

It is clearly obvious from the above discussion that the prevalence of mental distress is higher in non-western countries than western ones. This might be due to low knowledge and awareness about mental health in developing countries [34]. But there is evidence that western institutes did introduce curricular changes, better assessment, and innovation to cope with stress [20].
